If you have breasts...

If you read the news or watch TV in October, you probably know that breast cancer is the most common cancer among American women (except for skin cancers.) The chance of developing invasive breast cancer at some time in a woman's life is 1 in 8. Although the incidence is on the rise, the good news is that death from breast cancer is on the decline! (Caught early, breast cancer has a 98% 5-year survival.)

Most breast and ovarian cancer is not hereditary. As I always say to my patients: ‘if you have breasts, you are at risk for breast cancer.”  However, about 7% of breast cancer and 11 - 15% of ovarian cancer cases are caused by mutations in the BRCA1 or BRCA2  genes.  Those who test positive for one of these mutations have “Hereditary Breast and Ovarian Cancer” (HBOC) syndrome.  

If you have a personal or family history of certain cancers, you may want to be tested to see if you carry these mutations.  This can be done by a genetic counselor or in certain physicians’ offices.

In the past, I have referred my high-risk patients for genetic counseling, but I have been persuaded by the evidence that 80% of patients referred to a genetic counselor do not follow this recommendation.  Instead of risking a missed opportunity to obtain critical information on my patients, I will be offering the testing from my new office in Yorktown.

The best news for those squeamish about blood tests, the sample is easily obtained with a "swish and spit" of mouthwash.  If you are a candidate for testing (see below), our team will precertify with your insurance company before running the test.

Hereditary Cancer Testing for Breast Cancer

The following questions help determine whether someone has a higher risk for breast cancer because of their own and their family's history.

Knowing the potential risk can help you and your physician make better, more informed decisions about your health, before the onset of cancer or before a second cancer can develop. Testing should be considered for hereditary breast and ovarian cancer if:

Your History:

• Has had breast cancer at age 50 or younger
• Has had ovarian cancer at any age
• Is male and has had breast cancer at any age
• Is of Ashkenazi Jewish descent and has a personal or family history of breast, ovarian or pancreatic cancer

Your Family History:

• Has had two breast cancers in the same person or on the same side of the family
• Has had somebody diagnosed with triple negative breast cancer at any age
• Has had pancreatic cancer and an HBOC-associated cancer ( breast, ovarian and pancreatic) in the same person or on the same side of the family
• Has three or more family members with breast cancer on the same side of the family
• Has had a previously identified BRCA1 or BRCA2 mutation in the family

Why Find Out?
Because knowledge is power.  Power to know your risks and power to choose how to reduce your risks.  There is no single management strategy in reducing the risk of breast and ovarian cancer for all BRCA+ women. The choices include increasing surveillance, risk-reducing surgery, and/or chemoprevention.  These options need to be well-explained, individually tailored to each woman, and revisited at each visit to your physician.  For more info, see my website: drsuemalley.com.

Susan Malley, MD

Adolescent & Adult Gynecology

Children’s & Women’s Physicians of Westchester

Associate Professor of Gynecology

New York Medical College

914.302.7758, Yorktown